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Why Do Occupational Therapists Encourage Working on Vertical Surfaces?

Occupational therapists often incorporate activities on vertical surfaces into their sessions, especially when working with children. But why do occupational therapists work on vertical surfaces, and what makes this approach particularly effective for motor skill development? Recent research, such as a 2024 study by Ghoneim et al., highlights the benefits of vertical surface work in enhancing upper extremity skills in children with unilateral cerebral palsy (UCP). Learn more about various advantages of using vertical surfaces in therapy and provide simple, engaging ideas to implement these activities with kids.


BENEFITS OF CHILDREN WORKING ON VERTICAL SURFACES

Working on a vertical surface offers unique advantages for children’s motor skill development. Vertical surfaces—like walls, easels, or mirrors—challenge children to use different muscles than they would when working on a flat, horizontal surface. Here are some key benefits of incorporating vertical surfaces in occupational therapy:

  • Improves Shoulder Stability and Posture: Engaging with vertical surfaces requires children to lift their arms, promoting shoulder stability and helping to build endurance in the upper body. This positioning encourages better posture and strengthens the muscles around the shoulder girdle.
  • Enhances Fine and Visual Motor Skills: Activities on vertical surfaces demand eye-hand coordination and precise hand movements. Tasks such as drawing, tracing, or writing on a vertical surface can improve visual motor integration, which is crucial for tasks like reading and writing.
  • Encourages Wrist Extension: Working on a vertical surface naturally promotes wrist extension, an essential component for proper handwriting. This positioning is beneficial for children who may struggle with wrist flexibility or grip strength.
  • Strengthens Core Muscles: Since children need to stabilize their body while reaching up, using a vertical surface often engages their core muscles. This helps improve their overall balance and stability.
  • Increases Visual Attention and Focus: Vertical surfaces bring the activity directly into a child’s visual field, encouraging better focus. This positioning can make it easier for children to concentrate on tasks that might otherwise feel challenging on a horizontal surface.

These benefits highlight why therapists prioritize vertical surface activities, not only to build physical strength but also to support essential developmental skills.


SUPER SIMPLE VERTICAL SURFACE ACTIVITY IDEAS FOR KIDS

Using vertical surfaces in therapy or at home doesn’t have to be complex. Here are some simple, fun activities that help build upper body strength, fine motor skills, and visual motor integration:

  • Sticky Note Target Practice: Place sticky notes on a wall or easel and have the child reach up to grab them. You can even write letters or numbers on the notes, making it a playful learning exercise.
  • Wall Drawing with Chalk or Markers: Use a chalkboard wall, whiteboard, or even tape a large sheet of paper to the wall. Let kids draw, trace shapes, or practice writing. This activity enhances visual-motor skills and is great for promoting wrist extension.
  • Magnetic Letters on a Vertical Board: Arrange magnetic letters on a magnetic board or refrigerator. Have the child match letters, spell words, or categorize colors. This activity incorporates both fine and visual motor skills.
  • Vertical Puzzle Building: Use magnetic puzzle pieces on a whiteboard or refrigerator, or place felt pieces on a felt board. Completing puzzles on a vertical surface encourages children to reach, stretch, and build strength.
  • Tape and Stickers: Let kids stick painter’s tape or stickers onto a wall. They can create shapes or form letters, adding an element of creativity. Later, peeling the stickers off the wall is a great activity for finger strengthening and pincer grasp.

These ideas are easily adaptable and can be tailored to a child’s interests, making the experience more engaging and effective in building essential skills.


MORE UPPER EXTREMITY STRENGTHENING IDEAS

In addition to vertical surface activities, upper extremity strengthening exercises can further support motor skill development in children. These exercises are crucial for improving shoulder, arm, and hand strength, which are foundational for tasks such as writing, dressing, and self-feeding. Here are a few more ideas to consider:

  • Upper Body Exercises for Kids: This blog post offers a range of exercises to build strength in children’s upper bodies. Activities such as wheelbarrow walking, wall push-ups, and animal walks are fun, interactive, and perfect for group sessions or at-home practice.
  • Upper Extremity Strength Measurement in Children with Cerebral Palsy: Learn more about ways to measure upper extremity strength and track progress over time. This post is a helpful resource for occupational therapists working with children with cerebral palsy.
  • Coordination Exercises for Kids: Coordination exercises can complement strengthening activities, enhancing overall motor planning and movement control. This post includes ideas that improve bilateral coordination, core stability, and timing.
  • Posture Exercises for Kids: Good posture is vital for all motor activities. This post highlights exercises that reinforce core stability and postural control, which can directly support vertical surface activities and improve overall balance and strength.

RECENT RESEARCH TO SUPPORT THE BENEFITS OF USING VERTICAL SURFACES

A recent study conducted by Ghoneim et al. (2024) sheds light on the importance of working on vertical surfaces, specifically for children with unilateral cerebral palsy. The study compared two groups of children, one working on horizontal surfaces and the other on vertical surfaces, using intensive motor learning approaches like constraint-induced movement therapy and hand-arm bimanual intensive training. The results revealed significant improvements in the vertical surface group, particularly in upper limb motor skills. The study concluded that working on a vertical surface is more effective in promoting motor skills than working on a flat, horizontal surface.

Occupational therapists can incorporate these findings into their practice by utilizing vertical surfaces more frequently, as they encourage shoulder stability, fine motor precision, and improved visual-motor integration. This approach also makes therapy sessions more engaging and interactive, especially for young children who may need a more dynamic and stimulating environment to stay motivated.

Using vertical surfaces in occupational therapy can significantly benefit children’s motor skill development, offering a fun and effective way to build strength, coordination, and fine motor skills. Whether you’re a parent, teacher, or therapist, these simple activities and additional resources can make it easier to incorporate vertical surfaces into your daily routine and see positive improvements in the children you work with.

REFERENCE

Ghoneim, O. S. A., Galal, D. O. S. M., Al-Afify, D. H., El Ebrashy, M. H., Zidan, F. S., & Saad, R. A. (2024). Effectiveness of intensive motor learning approaches from working on a vertical surface on hemiplegic children’s upper limb motor skills, a randomized controlled trial. Disability and Rehabilitation, 1–7. https://doi.org/10.1080/09638288.2024.2407505